Disputes warning over care

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THE NEW system of care in the community will lead to disputes between health authorities and social services departments over where a person should be treated and who should pay, the Commons Health Select Committee was told yesterday.

The lack of definition of what constitutes health care as opposed to social care causes 'considerable confusion and uncertainty', according to the National Association of Health Authorities and Trusts (NAHAT). Martyn Long, its vice-chairman, told the committee: 'One of the biggest problems facing us is we have an NHS which is free and a social services system for which you pay. Unless you can agree that at some point the NHS stops and you should then move into social services care we are going to have disputes . . . It's going to be very difficult to solve the problems.'

Mr Long also warned that people could exploit the system and insist on staying in hospital which is free instead of going to a residential home which charges. 'It's only human to go to the system that's free,' he said.

Ray Rowden, chief executive of West Lambeth community trust, argued that such disputes should go to arbitration. The service should be delivered and then the authorities could later resolve how to apportion the costs. But he warned: 'If there are financial difficulties there may be a temptation for each authority to retire to their own corners.' Such a dispute would require arbitration.

NAHAT presented the results of a survey which showed 72 per cent of health authorities, 98 per cent of the 'providers' or hospitals, and 78 per cent of the Family Health Services Associations thought resources available for operating Care in the Community after 1 April were inadequate. 'All respondents identified increased demands on community health services as a major concern and commented that in the absence of additional resources the full intentions of community care plans were unlikely to be fulfilled.'